Provider Demographics
NPI:1457839870
Name:LOWRY, VICTORIA L (RN, BSN, MPH)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:L
Last Name:LOWRY
Suffix:
Gender:F
Credentials:RN, BSN, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 E CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:SAPULPA
Mailing Address - State:OK
Mailing Address - Zip Code:74066-4641
Mailing Address - Country:US
Mailing Address - Phone:918-224-9310
Mailing Address - Fax:918-224-9008
Practice Address - Street 1:1125 E CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:SAPULPA
Practice Address - State:OK
Practice Address - Zip Code:74066-4641
Practice Address - Country:US
Practice Address - Phone:918-224-9310
Practice Address - Fax:918-224-9008
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-30
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK117430163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse